    <div class="in_content">
    <div class="cent_content">
        <div class="content_F01"></div>
        <div class="content">
            <div class="tt_Chome">
                    <p>Đăng ký nhận email khuyến mãi</p>
                    
                </div>
            <div class="cc_Chome">
                	<div class="static_content">
                    	<table class="text_3" align="center" border="0" cellpadding="0" cellspacing="2" width="100%">
                    <tbody>
                      <tr valign="top">
                        <td width="28%"><div align="right"> <font color="#CC0000">(*)</font> Họ tên</div></td>
                        <td width="2%">&nbsp;</td>
                        <td width="70%"><input name="first_name" class="box_input" size="35" value=""></td>
                      </tr>
                      <tr valign="top">
                        <td><div align="right">Địa chỉ </div></td>
                        <td>&nbsp;</td>
                        <td><input name="address1" class="box_input" size="35" value=""></td>
                      </tr>
                      <tr valign="top">
                        <td><div align="right">Điện thoại </div></td>
                        <td>&nbsp;</td>
                        <td><input name="tel" class="box_input" size="35" value=""></td>
                      </tr>
                      <tr valign="top">
                        <td><div align="right"> <font color="#CC0000">(*)</font> Email </div></td>
                        <td>&nbsp;</td>
                        <td><input name="email" class="box_input" size="35" value=""></td>
                      </tr>
                      <tr valign="top">
                        <td><div align="right"><font color="#CC0000">(*)</font> Chủ đề </div></td>
                        <td>&nbsp;</td>
                        <td><input name="title" class="box_input" id="title" size="35" value=""></td>
                      </tr>
                      <tr valign="top">
                        <td><div align="right"><font color="#CC0000">(*)</font> Nội dung chi tiết</div></td>
                        <td>&nbsp;</td>
                        <td><textarea name="message" cols="35" rows="6" wrap="VIRTUAL" class="box_area"></textarea></td>
                      </tr>
                      
                      <tr valign="top">
                        <td height="65">&nbsp;</td>
                        <td>&nbsp;</td>
                        <td><input name="B1" class="submitbutton" value="  Gửi đi  " type="submit">
                          <input name="op" value="contactform" type="hidden">
                          <input name="lang" value="vn" type="hidden">
                          <input name="slug" value="lien-he" type="hidden">
                          &nbsp;
                          <input name="B2" class="submitbutton" value="  Nhập lại  " type="reset"></td>
                      </tr>
                    </tbody>
                  </table>
                    </div>
                </div>
           
        </div><!--content-->
        <div class="content_L01"></div>
    </div><!--cent_content-->
</div>